Opinions about persistent "burning" at the urethra tip

Male pelvic pain, prostatitis, IC
me07kn3
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Opinions about persistent "burning" at the urethra tip

Post by me07kn3 »

Dear Fellow Sufferers,

I have been experiencing continuously one and only symptom in the last 1.5 years; i. e. a burning urethra tip. I have received multiple medical diagnoses (i. e. chronic urethritis, chronic bacterial prostatitis, chronic non-bacterial prostatitis, chronic pelvic pain syndrome) from multiple doctors (i. e. 4 urologists, 1 neurologist, 1 CPPS expert) based on various tests (i. e. urethral swab cultures, uroflowmetry, pelvic ultrasound, transrectal ultrasound, MRI of the pelvic region, MRI of the prostate, MRI of the lumbar spine) and I have tried different therapies (i. e. antibiotics, alpha blockers, vitamin B complex for nerve healing, pelvic floor exercises) with no improvement.

From a pathological point of view the most characteristic results include (1) four cultures positive to intestinal bacteria, (2) white discharge collected twice from the interior of the urethra, (3) an MRI scan showing signs of chronic inflammation in the peripheral zone of the gland and mild bleeding elements on the right lateral edge of the gland and (4) red blood cells (10 per optical field) always appearing in my afternoon urine tests (not in the morning tests!).

As mentioned above, I had 3 urethral swab cultures and 1 semen culture during the past 18 months and all of them showed intestinal bacteria every single time.
  • 1st urethral swab: Enterococcus Faecalis
  • 2nd urethral swab: Enterobacter Cloacae & Coagulase-negative Staphyloccoci
  • 3rd urethral swab: Staphylococcus haemolyticus, Corynebacterium glucuronolyticum, Aerococcus Urinae & Enterobacter Cloacae
  • Semen culture: Pseudomonas Aeruginosa
Opinions and thoughts based on the above? which of the following cases are more relevant?
  1. Sample contamination all 4 times?
  2. Natural flora of the urethra and semen?
  3. Chronic bacterial infection of the urinary tract and/or prostate?
  4. Chronic non-bacterial inflammation of the prostate?
  5. Neuromuscular dysfunction?
  6. A combination of the above?
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webslave
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Re: Opinions about persistent "burning" at the urethra tip

Post by webslave »

The mere presence of bacteria is meaningless. You need to specify concentrations. Up to 105 is within normal bounds. The antibiotics you have been taking will upset the normal flora and unusual bacteria could be present as a result, but their presence is meaningless.

You most likely have a hypertonic pelvic floor, because penis tip discomfort is a classic sign of levator ani hypertonicity.
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me07kn3
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Re: Opinions about persistent "burning" at the urethra tip

Post by me07kn3 »

Hi webslave, many thanks for the prompt feedback. After more than 18 months since my "Day Zero", I am also convinced that my health issue could be related to some sort of neuromuscular dysfunction in the pelvic region. This symptom has originally appeared in a period where I was exercising intensively by lifting weights and doing deep squats. Could this be the reason? Stressing my pelvis too hard? I have been already assessed by a pelvic floor physiotherapist and he couldn't reproduce my discomfort. Is there any other way to diagnose a hypertonic pelvic floor or levator ani hypertonicity?
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Re: Opinions about persistent "burning" at the urethra tip

Post by webslave »

The diagnosis of hypertonic pelvic floor is more of an art than a science. It's highly operator specific. Many practitioners cannot find the sore areas in the muscles, either because if lack of training, lack of knowledge, or short fingers. Squats are notorious for provoking UCPPS, probably because of the "last straw that broke the camel's back" effect.

To get your pelvic floor properly assessed, travel to an expert. Don't rely on your local physio.
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me07kn3
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10 RBC in urine & hemoglobin traces in semen

Post by me07kn3 »

Dear All,

My urine tests, which are carried out in the afternoon (not the morning tests), always show red blood cells (usually 10 per optical field) while traces of hemoglobin were also found in my semen. Any thoughts? anyone has experienced something similar? :idea:
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Re: Opinions about persistent "burning" at the urethra tip

Post by webslave »

Microscopic hematuria is not significant.
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freemeofthis
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Re: Opinions about persistent "burning" at the urethra tip

Post by freemeofthis »

I have similar distal urethral inflammatory changes; I had cultures that were variably positive and took a bunch of 'bug juice' with no improvement. I had several samples sent to migrogendx and negative. I even had urethral biopsy and spoke to the pathologist personally who said it looked like nonspecific mild inflammation. I suspect your problem, like mine, is probably related to pelvic muscle spasm
Age: 48 | Onset Age: 44 | Symptoms: Groin/urethra pain, ejaculatory pain, ED, low libido, depression, joint pain, dysesthesias | Helped By: nothing significantly yet | Worsened By: stress, anger, lack of sleep | Other comments: seen multiple providers including famous urologist
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Re: Opinions about persistent "burning" at the urethra tip

Post by OM2023 »

I am struggle now two years against pain / burn in the urethra sphincter area at the tip of the penis. Doctors where doing one year a lot of research (lab tests), abdomen CT and MRI, with no helping data output.

At the end they prescribed me a healthy lifestyle and healthy nutrition, but without solution for my pain and burn.

There is also some pain from the right knee as an under skin burn and strong tighten, right hip touching sensitivity and orgasm needles pain, right side belly until belly button feels like foreign body sensation pain and spasm...

Admin comment: All common symptoms of UCPPS. Work through all recommendations here: https://ucpps.men/viewtopic.php?t=9338
Age: 44 | Onset Age: 42 | Symptoms: Pain from the belly button on the right side to the right knee | Helped By: still waiting to find | Worsened By: bad people | Other comments:
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OM2023
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Re: Opinions about persistent "burning" at the urethra tip

Post by OM2023 »

Admin comment: All common symptoms of UCPPS. Work through all recommendations here: https://ucpps.men/viewtopic.php?t=9338

Thanks for this very interesting and very complete info!
Age: 44 | Onset Age: 42 | Symptoms: Pain from the belly button on the right side to the right knee | Helped By: still waiting to find | Worsened By: bad people | Other comments: